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However, little is known about AI practice over the life course of women, to what extent AI practice is condom-protected, and whether it is associated with other HIV risk behaviors. We aim to describe longitudinal AI practice among HIV-seronegative women and to identify subgroups with distinct trajectories of AI practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the Women's Interagency HIV Study, an observational cohort of US women with or at risk for HIV, we described AI practice among HIV-seronegative participants. Group-based trajectory modeling was used to identify distinct AI trajectories. We used multinomial regression to examine associations between baseline characteristics and trajectory group membership.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A third of the 1,085 women in our sample reported any AI over follow-up (median follow-up = 14 years). AI decreased more sharply with age compared to VI. Consistent condom use during AI was low: twice the proportion of women never reported using condoms consistently during AI compared to during VI. 5 trajectory groups were identified: AI &amp; VI persistors (N = 75) practiced AI and VI consistently over follow-up (AI &amp; VI desistors (N = 169) tended to practice AI and VI when young only, while VI persistors (N = 549), VI desistors (N = 167), and AI &amp; VI inactives (N = 125) reported varying levels of VI practice, but little AI. AI &amp; VI persistors reported multiple male partners and exchange sex at more visits than other groups. Women who identified as bisexual\/lesbian (vs heterosexual), who had ever experienced physical and sexual violence (vs never), and\/or who reported above the median number of lifetime male sex partners (vs median or below) had approximately twice the odds of being AI &amp; VI persistors than being VI persistors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We identified a small subgroup of women who practice AI and report inconsistent condom use along with other risk behaviors throughout the life course; they may therefore particularly benefit from ongoing access to HIV prevention services including pre-exposure prophylaxis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.jsxm.2020.06.007","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T17:16:36Z","timestamp":1595265396000},"page":"1629-1642","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":8,"title":["Patterns and Trajectories of Anal Intercourse Practice Over the Life Course Among US Women at Risk of HIV"],"prefix":"10.1093","volume":"17","author":[{"given":"Branwen Nia","family":"Owen","sequence":"first","affiliation":[{"name":"Department of Infectious Disease Epidemiology , London , UK"},{"name":"Imperial College , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca F.","family":"Baggaley","sequence":"additional","affiliation":[{"name":"Department of Respiratory Sciences , Leicester , UK"},{"name":"University of Leicester , Leicester , UK"},{"name":"University Road , Leicester , 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